Response to temozolomide in second-line treatment of recurrent nonsmall cell lung carcinoma: Case report

Almost all patients with stage IV nonsmall cell lung cancer (NSCLC) who show an initial response to chemotherapy will eventually relapse. For patients with a good performance status at relapse, second-line chemotherapy is a standard treatment option. A case of recurrent NSCLC described herein profiles a patient previously treated with cisplatin, irinotecan, and radical thoracic radiation for stage IIIb NSCLC. The patient showed a complete response to first-line therapy that lasted for approximately 17 months. When new adenopathy was discovered, therapy with the oral chemotherapeutic agent temozolomide was initiated. After 2 treatment cycles, a near complete response was obtained and she remained free from disease progression during all subsequent treatment cycles with temozolomide. The patient remained free from disease progression for a total of 15 months when she was treated for dehydration and a computed tomography (CT) scan showed new small bilateral pleural effusions and enlarging subcarinal, right hilar, and left infrahilar lymph nodes. The patient died 21 months after her first treatment cycle with temozolomide, most likely because of progressive disease.